Traditional Enucleation Research Articles

Stain-free enucleation of mouse and human oocytes with a 1033nm femtosecond laser.

Preparation of a recipient cytoplast by oocyte enucleation is an essential task for animal cloning and assisted reproductive technologies in humans. The femtosecond laser is a precise and low-invasive tool for oocyte enucleation, and it should be an appropriate alternative to traditional enucleation by a microneedle aspiration. However, until recently, the laser enucleation was performed only with applying a fluorescent dye. This work is aimed to (1)achieve femtosecond laser oocyte enucleation without applying a fluorescent dye and (2)to study the effect of laser destruction of chromosomes on the structure and dynamics of the spindle. We applied polarized light microscopy for spindle visualization and performed stain-free mouse and human oocyte enucleation with a 1033nm femtosecond laser. Also, we studied transformation of a spindle after metaphase plate elimination by a confocal microscopy. We demonstrated a fundamental possibility of inactivating the metaphase plate in mouse and human oocytes by 1033nm femtosecond laser radiation without applying a fluorescent dye. Irradiation of the spindle area, visualized by polarized light microscopy, resulted in partly or complete metaphase plate destruction but avoided the microtubules impairment. After the metaphase plate elimination, the spindle reorganized, however, it was not a complete depolymerization. This method of recipient cytoplast preparation is expected to be useful for animal cloning and assisted reproductive technologies.

Femtosecond laser oocyte enucleation as a low-invasive and effective method of recipient cytoplast preparation.

Recipient cytoplast preparation, commonly performed by DNA aspiration with a needle, inevitably leads to the loss of reprogramming factors. As an alternative to the traditional enucleation technique, femtosecond laser enucleation can eliminate DNA effectively without loss of reprogramming factors and without oocyte puncturing. In this work we have performed oocyte enucleation by destructing the metaphase plate using a 795 nm femtosecond laser. The disability of the enucleated oocytes to develop after the parthenogenetic activation, as well as the lack of DNA staining luminescence, strongly confirms the efficiency of the femtosecond laser enucleation. The parthenogenetic development of oocytes after the cytoplasm treatment suggests a low-invasive effect of the laser enucleation technique.

Endoscopic-assisted enucleation of large mandibular odontogenic cysts.

Traditional enucleation of large mandibular odontogenic cysts is an invasive method, which might be associated with several complications. The purpose of this study was to evaluate the clinical outcome of endoscope-assisted enucleation of large mandibular cysts. Fifty-seven patients with large mandibular odontogenic cysts were enrolled in this study. Patients were divided into 2 groups as follows: (1) 25 patients who were treated with traditional enucleation and (2) 32 who underwent endoscope-assisted enucleation. Allogeneic bone grafting was applied in all cases. All patients successfully underwent the operation. The follow-up period ranged from 16 to 28 months. Recurrence was found in 2 patients (8%) in the traditional enucleation group; no recurrence was observed in patients in the endoscope-assisted enucleation group. Permanent mandibular nerve palsy was found in 2 patients in the traditional enucleation group; only 2 cases of temporary mandibular nerve palsy were observed in the endoscope-assisted enucleation group. Endoscope-assisted enucleation of large mandibular odontogenic cysts proved to be an effective treatment method, providing complete enucleation of the cystic lesion while preserving surrounding tissue.

Holmium Laser Enucleation of the Prostate.

Holmium laser enucleation of the prostate (HoLEP) offers superior voiding outcomes to traditional transurethral resection and less morbidity than open simple prostatectomy. Likewise, HoLEP has been determined to result in excellent outcomes regardless of gland size. We present a step-by-step surgical approach to HoLEP describing both the traditional enucleation technique and a modified "top-down" surgical technique. In this video, two techniques are presented that were performed by two (A.E.K., J.E.L.) surgeons at our institution. In the examples of the two enucleation techniques mentioned, outcomes are similar with regard to surgical and functional outcomes. HoLEP as a treatment for BPH with associated lower urinary tract symptoms (LUTS) results in excellent patient outcomes and can be offered to patients regardless of prostate volume.

Integrated versus non-integrated orbital implants for treating anophthalmic sockets.

Anophthalmia is the absence of one or both eyes, and it can be congenital (i.e. a birth defect) or acquired later in life. There are two main types of orbital implant: integrated, whereby the implant receives a blood supply from the body that allows for the integration of the prosthesis within the tissue; and non-integrated, where the implant remains separate. Despite the remarkable progress in anophthalmic socket reconstruction and in the development of various types of implants, there are still uncertainties about the real roles of integrated (hydroxyapatite (HA), porous polyethylene (PP), composites) and non-integrated (polymethylmethacrylate (PMMA)/acrylic and silicone) orbital implants in anophthalmic socket treatment. To assess the effects of integrated versus non-integrated orbital implants for treating anophthalmic sockets. We searched CENTRAL (which contains the Cochrane Eyes and Vision Trials Register) (2016, Issue 7), Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE (January 1946 to August 2016), Embase (January 1980 to August 2016), Latin American and Caribbean Health Sciences Literature Database (LILACS) (1982 to August 2016), the ISRCTN registry (www.isrctn.com/editAdvancedSearch), ClinicalTrials.gov (www.clinicaltrials.gov), and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). We did not use any date or language restrictions in the electronic searches for trials. We last searched the electronic databases on 8 August 2016. Randomised controlled trials (RCTs) and quasi-RCTs of integrated and non-integrated orbital implants for treating anophthalmic sockets. Two authors independently selected relevant trials, assessed methodological quality and extracted data. We included three studies with a total of 284 participants (250 included in analysis). The studies were conducted in India, Iran and the Netherlands. The three studies were clinically heterogenous, comparing different materials and using different surgical techniques. None of the included studies used a peg (i.e. a fixing pin used to connect the implant to the prosthesis). In general the trials were poorly reported, and we judged them to be at unclear risk of bias.One trial compared HA using traditional enucleation versus alloplastic implantation using evisceration (N = 100). This trial was probably not masked. The second trial compared PP with scleral cap enucleation versus PMMA with either myoconjunctival or traditional enucleation (N = 150). Although participants were not masked, outcome assessors were. The last trial compared HA and acrylic using the enucleation technique (N = 34) but did not report comparative effectiveness data.In the trial comparing HA versus alloplastic implantation, there was no evidence of any difference between the two groups with respect to the proportion of successful procedures at one year (risk ratio (RR) 1.02, 95% confidence interval (CI) 0.95 to 1.09, N = 100, low-certainty evidence). People receiving HA had slightly worse horizontal implant mobility compared to the alloplastic group (mean difference (MD) -3.35 mm, 95% CI -4.08 to -2.62, very low-certainty evidence) and slightly worse vertical implant motility (MD -2.76 mm, 95% CI -3.45 to -2.07, very low-certainty evidence). As different techniques were used - enucleation versus evisceration - it is not clear whether these differences in implant motility can be attributed solely to the type of material. Investigators did not report adverse events.In the trial comparing PP versus PMMA, there was no evidence of any difference between the two groups with respect to the proportion of successful procedures at one year (RR 0.92, 95% CI 0.84 to 1.01, N = 150, low-certainty evidence). There was very low-certainty evidence of a difference in horizontal implant motility depending on whether PP was compared to PMMA with traditional enucleation (MD 1.96 mm, 95% CI 1.01 to 2.91) or PMMA with myoconjunctival enucleation (-0.57 mm, 95% CI -1.63 to 0.49). Similarly, for vertical implant motility, there was very low-certainty evidence of a difference in the comparison of PP to PMMA traditional (MD 3.12 mm 95% CI 2.36 to 3.88) but no evidence of a difference when comparing PP to PMMA myoconjunctival (MD -0.20 mm 95% CI -1.28 to 0.88). Four people in the PP group (total N = 50) experienced adverse events (i.e. exposures) compared to 6/100 in the PMMA groups (RR 17.82, 95% CI 0.98 to 324.67, N = 150, very low-certainty evidence).None of the studies reported socket sphere size, cosmetic effect or quality of life measures. Current very low-certainty evidence from three small published randomised controlled trials did not provide sufficient evidence to assess the effect of integrated and non-integrated material orbital implants for treating anophthalmic sockets. This review underlines the need to conduct further well-designed trials in this field.

Endoscope-Assisted Enucleation of Mandibular Odontogenic Keratocyst Tumors.

The keratocyst odontogenic tumor (KCOT) represents a rare and benign but locally aggressive developmental cystic lesion usually affecting the posterior aspect of the mandible bone, the treatment of which has always been raising debate, since Philipsen first described it as a distinct pathological entity in 1956.Recent studies have proposed the use of endoscope-assisted surgical technique, due to the possibility given by the endoscope of improving the effectiveness of the treatment of these lesions thanks to a better visualization of operative field and though a better understanding of the pathology. In this article, we would like to present our experience with the endoscope-assisted treatment of KCOT of the posterior region of the mandible.From April 2000 to April 2012, 32 patients treated for KCOT were enrolled in our retrospective study: patients were divided in 2 groups according to the type of treatment, that is, 18 were treated with traditional enucleation surgery (TES), and 14 patients underwent endoscopic assisted enucleation surgery (EES).Fischer exact test and Kaplan-Meier curves were used to compare the outcomes between the 2 focusing on the recurrence and complication rates. In the TES group, patients we found a higher recurrence rate (39%) and higher postoperative complication rate at 5-year follow-up.Our data suggested, though, that EES seems to be a feasible alternative for the treatment of posterior mandibular KCOT. Further studies and larger series are needed to confirm these results.

Scintillating advances on somatic cell nuclear transfer and the implications for human ARTs

Scintillating advances on somatic cell nuclear transfer and the implications for human ARTs

Implant and Prosthesis Movement after Enucleation: A Randomized Controlled Trial

To evaluate implant and prosthesis movement after myoconjunctival enucleation and subsequent polymethyl methacrylate (PMMA) implantation, compared with the traditional enucleation with muscle imbrication using a PMMA implant and with enucleation accompanied by porous polyethylene implantation. Randomized, controlled, observer-masked, interventional study. One hundred fifty patients, equally and randomly allocated to the 3 groups. Group 1 consisted of patients in whom a PMMA implant was used after enucleation with muscle imbrication (traditional PMMA group). Group 2 consisted of patients in whom a PMMA implant was used after enucleation with a myoconjunctival technique (myoconjunctival PMMA group). Group 3 consisted of patients in whom a porous polyethylene implant was used after enucleation by the scleral cap technique (porous polyethylene group). Fifty patients were included in each group. Patients were allocated to 1 of the 3 groups using stratified randomization. Informed consent was obtained. Acrylic prostheses custom made by a trained ocularist were fitted 6 weeks after surgery in all patients. A masked observer measured implant and prosthesis movement 6 weeks after surgery using a slit-lamp device with real-time video and still photographic documentation. Analysis of implant and prosthesis movement was carried out using the Mann-Whitney U test, and a P value of < or =0.03 was considered significant. Complications including implant displacement and exposure also were noted. Implant and prosthesis movement. Myoconjunctival PMMA implant movement was better than the traditional PMMA implant (P = 0.001), but was similar to that of the porous polyethylene implant. Prosthesis movement with the myoconjunctival PMMA implant was better than that of either the traditional PMMA (P = 0.001) or porous polyethylene (P = 0.002) implants. Myoconjunctival enucleation technique with a PMMA implant provides statistically and clinically significantly better implant and prosthesis movement than the traditional PMMA implant and better prosthesis movement than the porous polyethylene implant.

77 BOVINE CYTOPLASTS PREPARED BY DEMECOLCINE-INDUCED ENUCLEATION OF ACTIVATED OOCYTES

One of the most critical steps of the standard NT procedure is the removal of oocyte chromosomes for the production of enucleated cytoplasts. This process involves ultraviolet (UV) irradiation, which causes damage to the membrane and intracellular components of bovine oocytes. The objective of the present study was to evaluate the use of demecolcine, a microtubule depolymerizing agent, for chemical-induced enucleation of activated bovine oocytes. In the first experiment, oocytes obtained from cow ovaries collected in a slaughterhouse were IVM in TCM-199 medium supplemented with 10% FCS, FSH, hCG, estradiol, pyruvate, and amikacin for 26 h; then, they were artificially activated with 5 μM ionomycin for 5 min and 10 μg mL-1 cycloheximide for 4 h. The following groups were established: control, C (no activation and no demecolcine); activated, A (exposure only to activating agents); and demecolcine-exposed oocytes, DEME (activation for 4 h and 0.05 μg mL-1 demecolcine for 2 to 4 h after 0, 0.5, 1.0, 1.5, and 2.0 h of activation). The treatment DEME comprised the groups G1 (demecolcine from 0 to 2 h of activation; DEME 0-2 h); G2 (DEME 0-4 h); G3 (DEME 0.5-2.5 h); G4 (DEME 0.5-4 h); G5 (DEME 1-3 h); G6 (DEME 1-4 h); G7 (DEME 1.5-3.5 h); G8 (DEME 1.5-4 h); and G9 (DEME 2-4h). The oocytes were stained with 10 μg mL-1 Hoechst 33342 for 15 min and enucleation rates (EN) were evaluated under epifluorescence microscope (330-385 nm).After EN evaluation, a second experiment was performed to verify the efficiency of demecolcine-induced enucleation in group G9, which showed the best result in the first experiment. After demecolcine treatment, the oocytes were incubated in HEPES-buffered SOF with 10% FCS and cytochalasin B for removal of the 2PB and minimal adjacent cytoplast under an inverted optical microscope. Traditional enucleation was performed on the control group without exposure of the oocytes to demecolcine. The same conditions were employed except that UV light was used to confirm enucleation. Samples of cytoplasts were stained with Hoechst for 15 min and analyzed for enucleation efficiency. Five and 3 replicates were evaluated, respectively, in experiments 1 and 2, and the results were analyzed by chi-square test in the statistical software Minitab®, release 14.1 (Minitab Inc., State College, PA, USA). A level of 5% significance was used. Regarding enucleation rates, all treated groups were significantly different compared with the C (0/114) and A (0/130) groups. Considering the DEME groups, G8 (46/109; 42.2%) and G9 (61/113; 54.0%) presented superior rates (P &lt; 0.05) to all other groups (26.8 to 36.3%), but they were similar despite the great tendency (P = 0.07) to difference. We observed high efficiency (P &lt; 0.05) of demecolcine-induced enucleation (90/110; 81.8%) compared with a traditional technique (61/95; 64.2%). In conclusion, the present study shows that demecolcine-induced enucleation of activated oocytes enables good rates of enucleation and has greater efficiency than the traditional technique as well as avoiding UV irradiation of the cytoplast. FAPESP 06/51481-5 and 07/55969-5

Transpalpebral enucleation using a chain écraseur

SummaryThis study was undertaken to describe the technique, complications and outcome of the use of a chain écraseur for transpalpebral enucleation in horses under general anaesthesia. We report its use in 53 horses, reviewing the subject details, reasons for enucleation, surgical technique, intra‐ and post operative complications, and long‐term outcome.Intraoperative complications included mild to moderate bleeding in 4 horses. Post operative complications included mild periorbital post operative swelling in one horse, transient head tilt in one horse and severe enterocolitis, which resulted in euthanasia in one horse; another 2 horses were subjected to euthanasia after long bone fractures that occurred during recovery from general anaesthesia and 2 horses had the prosthesis removed as a result of inflammatory reaction or infection.Long‐term outcome was available for 38 horses, 25 of which returned to their previous activities and 13 were retired. Twelve horses were lost for follow‐up.Transpalpebral enucleation using a chain écraseur is a feasible alternative to traditional enucleation techniques that can provide adequate haemostasis during transection of the optic pedicle when used properly.

33 ENUCLEATION OF PRE-ACTIVATED MOUSE OOCYTES INDUCED BY DEMECOLCINE, NOCODAZOLE, AND VINBLASTINE

Demecolcine-induced enucleation has been previously used to prepare developmentally competent enucleated mouse and bovine cytoplasts for nuclear transfer (Gasparrini et al. 2003 Biol. Reprod. 68, 1259–1266; Fischer-Russell et al. 2005 Mol. Reprod. Dev. 72, 161–170). The approach is technically simple, but the proportion of pre-activated oocytes that extrude all of the chromatin within the second polar body (PB) after exposure to demecolcine is relatively low, especially in the mouse (20%). This study was designed to explore the potential of other antimitotic drugs (nocodazole and vinblastine), besides demecolcine, to induce enucleation of mouse oocytes and to characterize the morphological progression of the treated oocytes after drug removal. Metaphase II (MII) oocytes were collected from cytochalasin D-1 (CD-1) females (6–12 weeks old) at 16 h post-hCG, activated in 7% ethanol (for a fast release from MII arrest) for 5 min and immediately treated for 15, 30, or 60 min with demecolcine (DEM, 0.4 �g mL-1), nocodazole (NOC, 0.3 �g mL-1), or vinblastine (VIN, 0.1 �g mL-1), prepared in calcium-free KSOM containing 10 mM strontium. Then, the oocytes were cultured in drug-free medium for up to 2 h, 6 h, or 20 h post-activation (p.a.) and fixed in a microtubule stabilization buffer-extraction fixative. A triple-labelling protocol for microtubules, microfilaments, and chromatin was used to analyze oocytes (approximately 60 per treatment) by fluorescence microscopy. Results were statistically analyzed by chi-square. At 2 h p.a., the highest rates of enucleation were achieved when pre-activated oocytes were treated with VIN (63.8%) or NOC (41.9%) for 15 min or with DEM (66.1%) for 30 min. Although antimitotic treatments did not affect activation rates (91.8–100%), a significant proportion of DEM- (19.6%) and of VIN-treated (15.5%) oocytes failed to complete second PB extrusion when compared to control (0%) or NOC-treated (4.8%) oocytes. From the total of the enucleated oocytes, 11.5%, 24.3%, and 29.7% had an incomplete second PB extrusion in NOC, VIN, and DEM groups, respectively, and therefore were classified as partially enucleated. Further culture of oocytes after drug withdrawal resulted in 100% of activated oocytes having a completely extruded second PB in all groups by 6 h p.a. and resulted in a significant and similar decrease in enucleation rates for all treatments by 6 h (20.3–34.9%) and 20 h p.a. (10.2–16.1%). This decrease might be caused by the reintegration of the chromosomes into the oocyte after incomplete second PB extrusion, or by re-fusion of second PBs to enucleated oocytes. Thus, our results show that both VIN and NOC, in addition to DEM, can be successfully applied to produce enucleated mouse cytoplasts, omitting the potentially harmful step (staining and ultraviolet illumination) of the traditional enucleation method. However, removal of the second PB at 2 h p.a. is recommended in order to achieve an irreversible oocyte enucleation. It remains to be demonstrated if the cytoplasts prepared with VIN or NOC are as competent as those prepared by DEM to support embryo development to term after being reconstructed by nuclear transfer.

75HIGHLY EFFICIENT AND RELIABLE CHEMICALLY ASSISTED ENUCLEATION METHOD FOR HANDMADE CLONING IN CATTLE AND SWINE

In bovine and porcine nuclear transfer, most traditional enucleation procedures require potentially harmful chromatin staining and UV illumination. The purpose of our work was to find an efficient and reliable chemically-assisted procedure for enucleation connected to the handmade cloning (HMC) technique without chromatin staining. Slaughterhouse-derived oocytes were collected and matured in vitro. At 21 (bovine) or 43 (porcine) h after the start of maturation, cumulus cells were removed with vortexing and oocytes were further incubated in the maturation medium supplemented with 0.5μgmL−1 demecolcine for 2h. Subsequently, zonae pellucidae were digested with 2mgmL−1 pronase in the presence of 10% cattle serum (CS) for 6 to 8min and washed in HEPES-buffered TCM-199 medium and 20% CS. Bisection was performed in the same medium by hand under a stereomicroscope by using a microblade. A small membrane protrusion observable on the surface of oocytes was used as an orientation point. One-third of the cytoplasm connected to this protrusion was removed, and the cytoplasts and karyoplasts were collected separately. Bovine cytoplasts were used as recipients for HMC experiments (Vajta et al., 2003, Biol. Reprod. 68, 571–578) with fetal fibroblasts as donors, and reconstructed embryos were cultured for 7 days. In Experiment 1 (3 replicates), the possibility of oriented bisection at different time points was determined on a total of 225 bovine oocytes. At 5, 15, 25, 35 and 55min after the end of pronase digestion 64, 91, 93, 72 and 59% of oocytes had membrane protrusions (P&amp;lt;0.05 between all groups, SAS Genmod) illustrating the time-dependent manner of the protrusion. In Experiment 2, the efficiency and reliability of enucleation was measured. Bisection was performed between 5 and 35min after pronase digestion. Subsequently both supposed cytoplasts and karyoplasts were stained with Hoechst and investigated under UV light. In cattle (9 replicates), bisection was successfully performed in 94% (519/552) of oocytes, and 98% (507/517) of those bisected were enucleated, i.e. the chromatin was entirely in the presumptive karyoplast. In swine (3 replicates), 91% (302/331) of oocytes were successfully bisected and 95% (280/296) were enucleated. In Experiment 3 (cattle; 4 replicates), blastocyst per reconstructed embryo rates were 47% (139/293), illustrating the high developmental ability in vitro. Considering that no oocyte selection based on the presence of polar body was performed, the above system seems to be more efficient and reliable than other enucleation methods. Moreover, expensive equipment (inverted fluorescent microscope) and a potentially harmful step (staining and UV illumination) can be eliminated from the HMC without compromising the high in vitro efficiency.